Uterine Artery Doppler Blood flow in Cases of Hydatidiform Mole and its Correlation with β-hCG | ||
| IRAQI JOURNALOF COMMUNITY MEDICINE | ||
| Article 1, Volume 27, Issue 1, December 2014, Pages 1-9 | ||
| Authors | ||
| Ahmed Abd Al-Jabbar Al-Sabbagh; ak Abd-EL-Kareem; Haider Fa; Rasha Najah Yassen; Neda Salih Amin | ||
| Abstract | ||
| Abstract Background: Gestational trophoblastic disease (GTD) is an uncommon complication of pregnancy, worldwide the incidence of GTD varies reportedly between 0.5 & 0.8 cases per 1000 live births. β-hCG has been used as standard tool for monitoring the biological activity of trophoblastic diseases and as a tumour marker. The abundant vascular supply of the tumour makes Colour Doppler Ultrasound a potentially useful tool to study the correlation of tumour’s blood flow and its clinical behaviour. Objective: To study the changes in the Doppler blood flow velocity of the uterine artery, the correlation between resistance indices & β-hCG level before and after evacuation of molar pregnancy as well as the value of Doppler flow in assessing the course of the disease. Patients and Methods: A-longitudinal study was conducted in AL-YARMOUK Teaching Hospital, Department of Obstetrics & Gynaecology, from Jan.2006 through Jan.2007. Twenty five cases of vesicular mole entered the study and were assessed before and after evacuation of the uterus by measuring serum β-hCG level and finding its relation with changes in the blood flow of the uterine artery using Doppler indices namely Systolic/ Diastolic (S/D), Resistance Index (RI), and Pusatility Index (PI). Results: Twenty two out of twenty five cases showed continuous decrease of their β-hCG serum level from pre-evacuation value of 1724.23 + 997.32 IU/L until it reached a value of 74.68 + 43.96 IU/L in the 6th week after evacuation.(P value = 0.0001), The Twenty two cases also showed continuous increase of all Doppler indices from pre-evacuation level to 6th week after evacuation as shown below: S/D pre-evacuation = 2.25 + 0.77 IU/L reached 10.12 + 0.79 IU/L in the 6th week post-evacuation. PI pre-evacuation =0.96 + 0.26 IU/L reached 4.1 + 1.08 IU/L in the 6th week post-evacuation. RI pre-evacuation =0.47 + 0.07 IU/L reached 0.95 + 0.08 IU/L in the 6th week post-evacuation. Two patients showed no consistent decrease of β-hCG serum level with plateuing of all Doppler indices for which Dilatation & Curettage (D&C) revealed Persistent Gestational Trophobastic Disease (PGTD). One patient showed significant increase of β-hCG serum level in the 6th week post-evacuation with drop of all Doppler indices. There was significant correlation (P value < 0.05) between β-hCG serum levels and Doppler indices throughout the course of follow-up: β-hCG & S/D(r) = - 0.778, β-hCG & RI(r) = - 0.581, β-hCG & PI(r) = - 0.483, Conclusion: Finding such a significant correlation between β-hCG serum level and Doppler indices suggest that colour Doppler may be used to predict the course of the disease and define its course. Keywords: Gestational Trophoblastic Disease (GTD), molar pregnancy, β-hCG level, Doppler indices. | ||
| Keywords | ||
| Gestational Trophoblastic Disease; molar pregnancy; hCG level; Doppler indices; GTD; HCG | ||
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